Diet-Related Lipidomic Signatures and Changed Type 2 Diabetes Risk in a Randomized Controlled Feeding Study With Mediterranean Diet and Traditional Chinese or Transitional Diets

Association between dietary patterns and glycemic control in type II diabetes mellitus patients

OBJECTIVE

To assess the association between dietary patterns and glycemic control among patients with type II diabetes mellitus (T2DM).

DESIGN

A cross-sectional study. SITE: The 2015-2018 National Health and Nutrition Examination Survey (NHANES).

PARTICIPANTS

A total of 1646 T2DM patients were included, of whom 854 were hyperglycemia.

METHODS

Main dietary patterns were identified using the sparse principal components analysis (SPCA). Logistic regression analysis was applied to investigate the association between each dietary pattern and the risk of hyperglycemia with odds ratios (OR) and 95% confidence intervals (CI). SPCA analysis yielded five significant principal components (PC), which represented five main dietary patterns.

RESULTS

PC1, characterized by a high intake of sweets, red meat and processed meat, was associated with higher odds of hyperglycemia in patients who underwent hyperglycemic drug or insulin treatments (OR: 1.71, 95% CI: 1.10-2.64). PC5, characterized by high in red meat, while low in coffee, sweets, and high-fat dairy consumption. The relationship between the PC5 and hyperglycemia was marginal significance (OR: 0.63, 95% CI: 0.38-1.02). PC2 was characterized by a high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat. In patients with the hyperglycemic drug and insulin free, higher PC2 levels were related to lower odds of hyperglycemia (OR: 0.45, 95% CI: 0.21-0.96).

CONCLUSIONS

High intake of sweets, red meat, and processed meat might be detrimental to glycemic control in patients with drug-treated T2DM. High in red meat, while low in coffee, sweets, and high-fat dairy consumption may be beneficial to glycemic control. In addition, high consumption of green vegetables, other vegetables, and whole grains, and low intake of potatoes and processed meat may be good for glycemic control in patients without drug-treated T2DM.

Serum Lipidomic Signatures Mediate the Association Between Coarse Grain Preference and Central Obesity in Adults With Normal Weight and High Wheat Intake

Little is known about the association between grain preference andabdominal fat accumulation, and mediating roles of circulating lipidomicsignatures. We quantified 1245 circulating lipids in 150 normal-weight centralobesity (NWCO) cases and 150 controls using targeted lipidomics. Grainpreference was determined by the highest intake frequency of grains (whiterice, wheat, or coarse grain). In our participants with high wheat intakefrequency, preferring coarse grain over rice was associated with a 60% lowerrisk of NWCO. Of the 585 lipids showing opposing associations with white riceand coarse grains, 46 were significantly linked to either (p < 0.05), predominantly alkylacyl phospholipids (PE-Os; n < 9) and alkenylacylphospholipids (PE-Ps; nx = 7). Network analysis identified a module primarilycomposed of PE-Os and PE-Ps, which was positively associated with coarse grain (p = 0.014). Another module, mainly consisting of triacylglycerols (TGs), was associatedwith white rice (p = 0.003) and mediated the association between white rice(mediation proportion: 20.30%; p = 0.027) or coarse grain preference (11.43%; p = 0.040) and NWCO. Specific lipids, such as TG(8:0_16:0_16:0) and TG(8:0_14:0_18:0), exhibited notable mediation effects. In normal-weight individuals with highwheat intake frequency, preferring coarse grain was inversely associated with NWCO, mediated by specific lipidomic signatures.

Mediterranean diet related to 3-year incidence of cognitive decline: results from a cohort study in Chinese rural elders

OBJECTIVE

This study aims to examine the effect of the Mediterranean diet (MeDi) on cognitive decline among the Chinese elderly with a 3-year follow-up.

METHODS

This study is divided into two waves: wave-1 January 2019 to June 2019 (n = 2313); wave-2 January 2022 to March 2022 (n = 1648). MeDi scores were calculated from the Mediterranean Diet Adherence Screener (MEDAS), with the scoring of low compliance (0-6 points) and high compliance (7-14 points). The Mini-Mental State Examination (MMSE) was used to assess cognitive function. An MMSE score dropping ≥ 2 points from baseline was defined as cognitive decline. The relationships between MeDi score and cognitive decline were analyzed by linear regression models or Binary logistic regression.

RESULTS

During the 3-year follow-up, 23.8% of patients exhibited cognitive decline. The study revealed a significant difference in MMSE score changes between low and high MeDi adherence groups (p < 0.001). MeDi score was negatively correlated with cognitive deterioration (β = -0.020, p = 0.026). MeDi score was only negatively associated with cognitive decline in the female subgroup aged ≥65 years (β = -0.034, p = 0.033). The food beans (OR = 0.65, 95%CI:0.51, 0.84), fish (OR = 0.72, 95%CI:0.54, 0.97), and cooked vegetables (OR = 0.68, 95%CI:0.53, 0.84) were protective factors for cognitive decline.

CONCLUSIONS

This study suggests that greater adherence to the MeDi is linked to a reduced risk of cognitive decline in elderly people. However, this is found only in women who are 65 years old or older. It also found long-term adherence to beans, fish, and vegetables are more effective in improving cognitive function.

Deep serum lipidomics identifies evaluative and predictive biomarkers for individualized glycemic responses following low-energy diet-induced weight loss: a PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World (PREVIEW) substudy

BACKGROUND

Weight loss through lifestyle interventions, notably low-energy diets, offers glycemic benefits in populations with overweight-associated prediabetes. However, >50% of these individuals fail to achieve normoglycemia after weight loss. Circulating lipids hold potential for evaluating dietary impacts and predicting diabetes risk.

OBJECTIVES

This study sought to identify serum lipids that could serve as evaluative or predictive biomarkers for individual glycemic changes following diet-induced weight loss.

METHODS

We studied 104 participants with overweight-associated prediabetes, who lost ≥8% weight via a low-energy diet over 8 wk. High-coverage lipidomics was conducted in serum samples before and after the dietary intervention. The lipidomic recalibration was assessed using differential lipid abundance comparisons and partial least squares discriminant analyses. Associations between lipid changes and clinical characteristics were determined by Spearman correlation and Bootstrap Forest of ensemble machine learning model. Baseline lipids, predictive of glycemic parameters changes postweight loss, were assessed using Bootstrap Forest analyses.

RESULTS

We quantified 439 serum lipid species and 9 related organic acids. Dietary intervention significantly reduced diacylglycerols, ceramides, lysophospholipids, and ether-linked phosphatidylethanolamine. In contrast, acylcarnitines, short-chain fatty acids, organic acids, and ether-linked phosphatidylcholine increased significantly. Changes in certain lipid species (e.g., saturated and monounsaturated fatty acid-containing glycerolipids, sphingadienine-based very long-chain sphingolipids, and organic acids) were closely associated with clinical glycemic parameters. Six baseline bioactive sphingolipids primarily predicted changes in fasting plasma glucose. In addition, a number of baseline lipid species, mainly diacylglycerols and triglycerides, were predictive of clinical changes in hemoglobin A1c, insulin and homeostasis model assessment of insulin resistance.

CONCLUSIONS

Newly discovered serum lipidomic alterations and the associated changes in lipid-clinical variables suggest broad metabolic reprogramming related to diet-mediated glycemic control. Novel lipid predictors of glycemic outcomes could facilitate early stratification of individuals with prediabetes who are metabolically less responsive to weight loss, enabling more tailored intervention strategies beyond 1-size-fits-all lifestyle modification advice. The PREVIEW lifestyle intervention study was registered at clinicaltrials.gov as NCT01777893 (https://clinicaltrials.gov/study/NCT01777893).

Exploring the design of clinical research studies on the efficacy mechanisms in type 2 diabetes mellitus

This review examines the complexities of Type 2 Diabetes Mellitus (T2DM), focusing on the critical role of integrating omics technologies with traditional experimental methods. It underscores the advancements in understanding the genetic diversity of T2DM and emphasizes the evolution towards personalized treatment modalities. The paper analyzes a variety of omics approaches, including genomics, methylation, transcriptomics, proteomics, metabolomics, and intestinal microbiomics, delineating their substantial contributions to deciphering the multifaceted mechanisms underlying T2DM. Furthermore, the review highlights the indispensable role of non-omics experimental techniques in comprehending and managing T2DM, advocating for their integration in the development of tailored medicine and precision treatment strategies. By identifying existing research gaps and suggesting future research trajectories, the review underscores the necessity for a comprehensive, multidisciplinary approach. This approach synergistically combines clinical insights with cutting-edge biotechnologies, aiming to refine the management and therapeutic interventions of T2DM, and ultimately enhancing patient outcomes. This synthesis of knowledge and methodologies paves the way for innovative advancements in T2DM research, fostering a deeper understanding and more effective treatment of this complex condition.

SGLT2 inhibition leads to a restoration of hepatic and circulating metabolites involved in the folate cycle and pyrimidine biosynthesis

Inhibition of sodium-glucose cotransporter 2 (SGLT2) by empagliflozin (EMPA) and other "flozins" can improve glycemic control under conditions of diabetes and kidney disease. Though they act on the kidney, they also offer cardiovascular and liver protection. Previously, we found that EMPA decreased circulating triglycerides and hepatic lipid and cholesterol esters in male TallyHo mice fed a high-milk-fat diet (HMFD). The goal of this study was to determine whether the liver protection is associated with a change in metabolic function by characterizing the hepatic and circulating metabolic and lipidomic profiles using targeted LC-MS. In both male and female mice, HMFD feeding significantly altered the circulating and hepatic metabolome compared with low-fat diet (LFD). Addition of EMPA resulted in the restoration of circulating orotate (intermediate in pyrimidine biosynthesis) and hepatic dihydrofolate (intermediate in the folate and methionine cycles) levels in males and acylcarnitines in females. These changes were partially explained by altered expression of rate-limiting enzymes in these pathways. This metabolic signature was not detected when EMPA was incorporated into an LFD, suggesting that the restoration requires the metabolic shift that accompanies the HMFD. Notably, the HMFD increased expression of 18 of 20 circulating amino acids in males and 11 of 20 in females, and this pattern was reversed by EMPA. Finally, we confirmed that SGLT2 inhibition upregulates ketone bodies including β-hydroxybutyrate. Collectively, this study highlights the metabolic changes that occur with EMPA treatment, and sheds light on the possible mechanisms by which this drug offers liver and systemic protection.NEW & NOTEWORTHY Sodium-glucose cotransporter 2 (SGLT2) inhibitors, including empagliflozin, have emerged as a new treatment option for individuals with type 2 diabetes that have positive impacts on kidney and cardiovascular disease. However, less is known about their impact on other tissues, including the liver. Here, we report that empagliflozin reduces hepatic steatosis that is associated with restoring metabolic intermediates in the folate and pyrimidine biosynthesis pathways. These changes may lead to new approaches to treat nonalcoholic fatty liver disease.

The Lipidomic Profile Is Associated with the Dietary Pattern in Subjects with and without Diabetes Mellitus from a Mediterranean Area

Lipid functions can be influenced by genetics, age, disease states, and lifestyle factors, particularly dietary patterns, which are crucial in diabetes management. Lipidomics is an expanding field involving the comprehensive exploration of lipids from biological samples. In this cross-sectional study, 396 participants from a Mediterranean region, including individuals with type 1 diabetes (T1D), type 2 diabetes (T2D), and non-diabetic individuals, underwent lipidomic profiling and dietary assessment. Participants completed validated food frequency questionnaires, and lipid analysis was conducted using ultra-high-performance liquid chromatography coupled with mass spectrometry (UHPLC/MS). Multiple linear regression models were used to determine the association between lipid features and dietary patterns. Across all subjects, acylcarnitines (AcCa) and triglycerides (TG) displayed negative associations with the alternate Healthy Eating Index (aHEI), indicating a link between lipidomic profiles and dietary habits. Various lipid species (LS) showed positive and negative associations with dietary carbohydrates, fats, and proteins. Notably, in the interaction analysis between diabetes and the aHEI, we found some lysophosphatidylcholines (LPC) that showed a similar direction with respect to aHEI in non-diabetic individuals and T2D subjects, while an opposite direction was observed in T1D subjects. The study highlights the significant association between lipidomic profiles and dietary habits in people with and without diabetes, particularly emphasizing the role of healthy dietary choices, as reflected by the aHEI, in modulating lipid concentrations. These findings underscore the importance of dietary interventions to improve metabolic health outcomes, especially in the context of diabetes management.

Dietary Patterns and Fertility

Diet has a key role in the reproductive axis both in males and females. This review aims to analyze the impacts of different dietary patterns on fertility. It appears that the Mediterranean diet has a predominantly protective role against infertility, while the Western diet seems to be a risk factor for infertility. Moreover, we focus attention also on dietary patterns in different countries of the World (Middle Eastern diet, Asian diet). In particular, when analyzing single nutrients, a diet rich in saturated fatty acids, cholesterol, animal proteins, and carbohydrates with high glycemic index is highly associated with male and female infertility. Finally, we evaluate the effects of vegetarian, vegan, and ketogenic diets on fertility, which seem to be still unclear. We believe that comprehension of the molecular mechanisms involved in infertility will lead to more effective and targeted treatments for infertile couples.

Lipidome and inflammation interplay: the role of diet in this relationship

PURPOSE OF REVIEW

The aim of this review was to provide an overview of the role of novel lipid biomarkers from the circulating lipidome in inflammatory processes and the impact that dietary patterns may have on the lipidome.

RECENT FINDINGS

Inflammation is a process that underlies many acute and chronic diseases, contributing to their development and severity. Finding novel molecules which serve as biomarkers and which are involved in inflammation is very useful, since they offer us both preventive or therapeutic targets and reveal mechanisms of action. Recently, several studies have found circulating lipid molecules that are implicated in inflammatory processes of different diseases, such as cardiovascular diseases, type 2 diabetes, COVID-19 or other respiratory infectious diseases. As such, ceramides, triacylglicerides or lysophosphatidylcholines have been associated with inflammation in a different manner depending on the stage of inflammation. The study of dietary patterns, especially healthy ones as the Mediterranean or the Nordic diets, has shown the impact that dietary habits may have on the lipidomic profile of individuals.

CONCLUSIONS

Healthy dietary patterns have been suggested to exert beneficial effects in the circulating lipid profile. Studying the circulating lipidome could help to find new biomarkers of underlying inflammation, especially in cases of chronic low-grade inflammatory diseases in which it is more difficult to detect.